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Test ID: PLASF Plasma Cell Proliferative Disorder, FISH, Tissue

Useful For

Supporting the diagnosis of plasmacytoma or myeloma when coordinated with a surgical pathology consultation

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
_I099 Interphases, 25-99 No, (Bill Only) No
_I300 Interphases, >=100 No, (Bill Only) No
_IL25 Interphases, <25 No, (Bill Only) No
_PADD Probe, +1 No, (Bill Only) No
_PB02 Probe, +2 No, (Bill Only) No
_PB03 Probe, +3 No, (Bill Only) No
_PBCT Probe, +2 No, (Bill Only) No

Testing Algorithm

This test does not include a pathology consult. If a pathology consult is requested, PATHC / Pathology Consultation should be ordered and the appropriate fluorescence in situ hybridization (FISH) test will be ordered and performed at an additional charge.

 

This test includes a charge for application of the first probe set (2 FISH probes) and professional interpretation of results. Additional charges will be incurred for all reflex probes performed. Analysis charges will be incurred based on the number of cells analyzed per probe set. If no cells are available for analysis, no analysis charges will be incurred.

 

A minimum of 25% plasma cell involvement is required for a successful paraffin plasma cell FISH evaluation. If a bone marrow clot specimen is submitted with less than 25% plasma cell involvement, the PLASF / Plasma Cell Proliferative Disorder, FISH, Tissue will be cancelled.

 

For decalcified (bone) specimens, one FISH probe (breakapart IGH) will be attempted. If this FISH probe is unsuccessful, the sample will be cancelled due to lack of hybridization due to the decalcification process. If the IGH FISH probe is successful, additional FISH probes will be evaluated based on the sample received (bone marrow clot vs. plasmacytoma) as listed below.

 

The initial panel for bone marrow clot specimens includes testing for the following abnormalities using the probes listed:

17p-, TP53/D17Z1

1q gain, TP73/1q22

14q32 rearrangement, IGH

 

Based on the results from the initial panel, reflex testing may be performed to identify the following abnormalities using the probes listed:

t(11;14)(q13;q32), CCND1/IGH

t(14;16)(q32;q23) IGH/MAF

t(4;14)(p16.3;q32) FGFR3/IGH

t(14;20)(q32;q12) IGH/MAFB 

 

The initial panel for plasmacytoma specimens includes testing for the following abnormalities using the probes listed:

17p-, TP53/D17Z1

1q gain, TP73/1q22

8q24.1 rearrangement, MYC

-13/13q-, RB1/LAMP1

+9/+15, D9Z1/D15Z4

+3/+7, D3Z1/D7Z1

14q32 rearrangement, IGH

t(11;14)(q13;q32), CCND1/IGH

 

Based on the results from the initial panel, reflex testing may be performed to identify the following abnormalities using the probes listed:

t(14;16)(q32;q23) IGH/MAF

t(4;14)(p16.3;q32) FGFR3/IGH

t(14;20)(q32;q12) IGH/MAFB 

t(6;14)(p21;q32), CCND3/IGH

 

This test is not designed for follow-up testing.

Method Name

Fluorescence In Situ Hybridization (FISH)

Reporting Name

Plasma Cell Prolif, FISH, Ts

Specimen Type

Tissue


Advisory Information


-For the most complete genetic evaluation on fresh bone marrow specimens, order MPCDS / mSMART, Plasma Cell Proliferative Disorder, FISH, Bone Marrow.

-For evaluation of high risk abnormalities plus CCND1/IGH fusion on fresh bone marrow specimens, order PCPDS / Plasma Cell Proliferative Disorder, FISH, Bone Marrow.

-For fixed cell pellet specimens, order MFCF / Myeloma, FISH, Fixed Cells.

-Testing will be changed to the appropriate test if this test is ordered on either of the previous specimen types.



Shipping Instructions


Advise Express Mail or equivalent if not on courier service.



Necessary Information


A reason for testing and pathology report are required in order for testing to be performed. Send information with specimen. Acceptable pathology reports include working drafts, preliminary pathology, or surgical pathology reports.



Specimen Required


Submit only 1 of the following specimens:

 

Specimen Type: Tissue

Preferred: Tissue block

Collection Instructions: Submit a formalin-fixed, paraffin-embedded (FFPE) tumor tissue block. Blocks prepared with alternative fixation methods may be acceptable; provide fixation method used.

 

Acceptable: Slides

Collection Instructions: For each probe set ordered, 2 consecutive, unstained, 5 micron-thick sections placed on positively charged slides, and 1 hematoxylin and eosin-stained slide.


Specimen Minimum Volume

See Specimen Required

Specimen Stability Information

Specimen Type Temperature Time Special Container
Tissue Ambient (preferred)
  Refrigerated 

Clinical Information

A plasmacytoma is a localized proliferation of plasma cells that are cytologically and immunophenotypically identical to the plasma cell clones seen in myeloma. There are 2 primary types of plasmacytomas; solitary plasmacytoma of bone (SPB) and extramedullary plasmacytoma (EP).

 

SPBs are a localized bone tumor comprised of plasma cells and account for about 5% of all plasma cell neoplasms. Common sites for SPBs are the vertebrae, ribs, skull, pelvis, femur, clavicle, and scapula. Patients often present with pathological fracture or bone pain near the lesion. Treatment is typically radiation therapy; at 10 years, 35% of patients appear to be cured, 55% develop myeloma, and 10% have local recurrence.

 

EPs are tumors of plasma cells that form in areas away from the bone and account for 3% to 5% of all plasma cell neoplasms. Approximately 80% of EPs occur in the upper respiratory tract. Less common locations include the gastrointestinal tract, bladder, testis, central nervous system, and skin. Treatment consists of radiation therapy. Regional recurrence develops in about 25% of patients, but development of myeloma is less frequent, occurring in only about 15% of patients.

 

Genetics of both types of plasmacytomas, while not extensively studied, appear to be the same as plasma cell myeloma.

 

Paraffin plasma cell fluorescence in situ hybridization (FISH) evaluation of bone marrow clot specimens is also important when a fresh bone marrow specimen is not available or is unsuccessful in the initial/diagnostic evaluation to document the genetic abnormalities associated with a patient’s plasma cell clone.

Reference Values

An interpretive report will be provided.

Interpretation

A neoplastic clone is detected when the percent of cells with an abnormality exceeds the normal reference range for a given probe set.

 

A positive result supports the diagnosis of a plasmacytoma or myeloma.

 

A negative result does not exclude the diagnosis of a plasmacytoma or myeloma.

Clinical Reference

1. Swerdlow S, Campo E, Harris NL, et al: WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. IARC Press; 2017

2. Nolan KD, Mone MC, Nelson EW: Plasma cell neoplasms: review of disease progression and report of a new variant. Surg Oncol. 2005;14:85-90

3. Dingli D, Kyle RA, Rajkumar SV, et al: Immunoglobulin free light chains and solitary plasmacytoma of bone. Blood. 2006;108(6):1979-1983

Day(s) and Time(s) Performed

Specimens are processed Monday through Sunday.

Results reported Monday through Friday, 8 a.m.-5 p.m.

Analytic Time

7 days

Test Classification

This test was developed using an analyte specific reagent. Its performance characteristics were determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

88271x2, 88291-DNA probe, each (first probe set), Interpretation and report

88271x2-DNA probe, each; each additional probe set (if appropriate)

88271x1-DNA probe, each; coverage for sets containing 3 probes (if appropriate)

88271x2-DNA probe, each; coverage for sets containing 4 probes (if appropriate)

88271x3-DNA probe, each; coverage for sets containing 5 probes (if appropriate)

88274 w/modifier 52-Interphase in situ hybridization, <25 cells, each probe set (if appropriate)

88274-Interphase in situ hybridization, 25 to 99 cells, each probe set (if appropriate)

88275-Interphase in situ hybridization, 100 to 300 cells, each probe set (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
PLASF Plasma Cell Prolif, FISH, Ts In Process

 

Result ID Test Result Name Result LOINC Value
52219 Result Summary 50397-9
52221 Interpretation 69965-2
52220 Result Table 93356-4
54593 Result 62356-1
CG753 Reason for Referral 42349-1
52222 Specimen 31208-2
52223 Source 31208-2
52224 Tissue ID 80398-1
52225 Method 49549-9
55033 Additional Information 48767-8
53823 Disclaimer 62364-5
52226 Released By 18771-6

Forms

If not ordering electronically, complete, print, and send a Hematopathology/Cytogenetics Test Request (T726) with the specimen.

Mayo Clinic Laboratories | Hematology Catalog Additional Information:

mml-myeloma-amyloidosis-dysprotenemia